Patient 1 | Patient 2 | Patient 3 | Patient 4 | Patient 5 | Patient 6 | |
Age (years) | 40 | 61 | 41 | 52 | 62 | 55 |
Sex | M | F | M | M | M | F |
Race | W | AA | W | W | W | W |
Prior systemic therapy | None | None | IL-2, Carboplatin/Paclitaxel | Interferon | None | None |
Prior brain radiotherapy (Y/N) | N | Y | N | N | N | Y |
Immunotherapy agent(s) | Ipilimumab+Nivolumab | Ipilimumab+Nivolumab | Nivolumab | Recombinant IL-21 +Nivolumab | Nivolumab | Pembrolizumab |
Intracranial metastasis (Y/N) | N | Y | N | Y | N | Y |
Other irAEs | Anterior uveitis, dermatitis | Hypophysitis | None | Dermatitis, arthritis | None | Thyroiditis, pancreatitis |
Other irAE treatments | Uveitis: prednisolone eye drops, cyclopentolate eye drops Inflammatory arthritis: topical triamcinolone, oral prednisone | Prednisone, levothyroxine | N/A | Inflammatory arthritis: celecoxib Dermatitis: benadryl | N/A | Thyroiditis: levothyroxine Pancreatitis: prednisone, infliximab |
Best response to ICI (RECIST v1.1) | Partial response | Partial response | Partial response | Partial response | Complete response | Progressive disease |
Laterality of hearing symptoms | Bilateral | Bilateral | Unilateral | Bilateral | Bilateral | Bilateral |
Time to ototoxicity symptoms from immunotherapy start (weeks) | 3 | 16 | 2 | 16 | 10 | 164 |
Number of ICI doses received prior to ototoxicity | 1 | 2 | 1 | 9 | 5 | 12 |
Total number of doses of ICI received | 1 | 4 | 48 | 26 | 32 | 12 |
Diagnostic evaluation and treatment for hearing loss | ||||||
Audiogram (Y/N) | Y | Y | Y | Y | Y | Y |
MRI brain with contrast (Y/N) | N | Y | N | Y | Y | Y |
Degree of SNHL | Moderate-severe | Moderate-severe | Moderate-severe to profound | Mild-moderate | None | Mild |
Symmetric vs asymmetric audiometry findings | Symmetric | Asymmetric | Asymmetric | Asymmetric | Symmetric | Asymmetric |
Reduction in speech reception thresholds (Y/N) | Y | Y | Y | N | N | N |
Reduction in word recognition ability (Y/N) | Y | N | Y | N | N | Y |
Ototoxicity treatment | Prednisone | Hearing aids | None | Hearing aids | Hearing aids (pt declined) | None |
Subjective change in hearing loss | Improved | Stable | Stable | Stable | Stable | Stable |
AA, African American; anti-PD-1, anti-programmed death-1; F, female; ICI, immune checkpoint inhibitor; IL, interleukin; irAE, immune-related adverse event; M, male; pt, patient; RECIST, response evaluation criteria in solid tumors; SNHL, sensorineural hearing loss; W, white.